Know the Meds, Part 1

The treatments for mental illness conditions vary from person to person, which doesn’t make things any easier.  People with the same diagnosis can have vastly different experiences with treatments and medications.

Of course, your loved one’s mental health provider is the best source for information about treatment.  Getting a HIPPA release so you can discuss the situation with them is very useful.  The articles in this series, based on information from NAMI and my experience, are general information to help you understand the treatment options when they are discussed.

Psychotropic, or psychiatric, medications influence the chemicals in the brain that regulate thinking and emotions.  While they can be more effective when combined with therapy, often a person needs the medication first to reduce symptoms to allow them to participate in the therapy.

Predicting what works is a challenge.  One field of research called pharmacogenetics does genetic testing to help determine how medications will interact with a person’s genes.  Some people I know have taken these tests, so it’s worth discussing it with the doctor. It’s also helpful to tell the doctor if a medication has worked well for someone else in the immediate family.

Another major challenge is that the medications rarely work instantly.  A person may need to take medication for as long as a few months to see a difference, which becomes even more irritating if side effects are causing issues.

To try to stop that, physicians usually start with small doses and build up to get to the point where the symptoms are better.  It’s important that your loved one does not stop medicine at once.  Usually, it’s better to taper off to avoid unpleasant effects.

The main categories of psychotropic medicine are:

  • Antipsychotics
  • Antidepressants
  • Anti-anxiety medicine
  • Mood stabilizers

We will look at each in this series.

15 Ways to Abide With Jesus

Want to enjoy the presence of Jesus in your life as a caregiver?  Here’s 15 steps to help you get there.

  1. Try a daily prayer of surrender. “Today, this is Your day… Today, I am Yours… May Your Spirit lead, guide and prompt me throughout my day… May I be sensitive to Your prompting and respond accordingly… Today, I surrender my life to You…
  2. Read a short section of Scripture or a devotional book as often as you eat.
  3. Pray Bible verses. Even if it’s just a few verses, pray the Bible back to God.  This is easier if you put up Bible verses around the house. That can be in framed calligraphy, a perpetual calendar of Biblical thoughts or simple Post-it notes.
  4. Be in the day with a plan and the willingness to disregard the plan to respond to what God allows.
  5. Keep focused on what you are doing. When you walk with Jesus, everything you do can be a prayer. This is where the practice of Christian mindfulness comes in.
  6. Listen to yourself and be compassionate. Overcoming restlessness and the need to focus on the trivial to avoid the pain of grief is a problem that I have, and I think many others who are caregivers of people with mental illness have as well. The Three Things exercise can help you to focus your attention, reduce restlessness and add calm: Stretch or drink some water. Note three things you see, three thinks you hear and three feelings you have. 
  7. Refocus during transitions. Try to center yourself as you move from place to place, from event to event. You can say:  I am calm, peaceful and aware of the presence of God as I enter this home/door/time/event.
  8. Carry on a conversation with God and try to make it continual.
  9. When you run out of words, say the Jesus prayer. Using a “Jesus” prayer when you need to calm down or you are in a situation in which you would just look at your phone helps. You can pray “Jesus, Jesus, Jesus” over and over.  I use “Come Holy Spirit.”  It’s also a nice way to go to sleep at night.
  10. Stop to praise God
  11. Be a “yes” to all that is in God and to each circumstance and person who comes into our lives. Have faith that God is at work even in horrible circumstances. We should look at all circumstances, environments, and even all persons as coming through God’s hands so we can serve Him. This is the “good” that all things work for as mentioned in Romans 8:28: 28 And we know that in all things God works for the good of those who love him, who have been called according to his purpose. Acceptance of this kind makes caregiving less depleting and exhausting.It’s so challenging, but you can accept the reality of the circumstance and not argue in your mind that it should be different.  Second, you also need listen to yourself rather than taking a treat (food, a drink or a nap). Acceptance is not the same as being happy in sad circumstances. You cannot pretend everything is fine, because your mind knows it’s not. Accepting that everything is not fine, but it is impossible for you to change allows you to offer more empathy without draining excessive energy. We are not in heaven yet, and bad things happen in a fallen world.  God is still present and wants to abide in you.  The joy of the Lord is your strength.  Follow an energy draining situation with an energy builder such as reading, meditation, pray, eating something healthy and tasty.
  12. In everything give thanks
  13. Think on these things. Philippians 4:8:Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable – if anything is excellent or praiseworthy – think about such things. I made up a phrase to help me remember this: The normal real person likes an excellent pizza. (true, noble, right, pure, lovely, admirable, excellent, praiseworthy).  This helps me to do a thought check when I seem to be on the wrong track.
  14. Give yourself a GIFT list.The GIFT list idea originated with Pam Young and Peggy Jones, and I adapted it to give myself something else to think about. I keep the daily list with my to-dos. GIFT stands for: Grace, Imagination, Focus and Thanksgiving.  I ask for a Grace from the list of the fruits of the Holy Spirit (love, joy, peace, patients, kindness, goodness, righteousness, gentleness and self-control). For Imagination, I pick a virtue and image how I could incorporate that virtue into my day.  Focus is the day’s predominate activities.  (Attending meetings, writing, planning, cleaning, making things, running errands, enjoying the family, taking a Sabbath, etc.)  And Thanksgiving is a gratitude list I fill out as the day goes on.  When my mind goes on a tear, I deliberately turn it back to the Grace, Imagination or Focus of the day.
  15. Summon up your courage and pray the welcoming prayer. This is the scariest prayer I’ve ever prayed: Welcome, welcome, welcome. I welcome everything that comes to me today because I know it’s for my healing. I welcome all thoughts, feelings, emotions, persons, situations and conditions. I let go of my desire for power and control.  I let go of my desire for affection, esteem, approval and pleasure. I let go of my desire for survival and security. I let go of my desire to change any situation, condition, person or myself.  I open t the love and presence of God and God’s action within. 

This practice of the presence of God, somewhat difficult in the beginning, when practiced faithfully, secretly brings about marvelous effects in the soul, draws down the abundance of God’s grace upon it, and leads it imperceptibly to this simple awareness, to this loving view of God present everywhere, which is the holiest, the surest, the easiest, and the most efficacious form of prayer. People who lean on Jesus know things that other people don’t know.

 

Why Low Expectations Are a Good Thing

How do you feel when you expect a $100 tax refund and the IRS finds a mistake in your favor, so you get $1,000 instead?

How about when you expect to wait for 10 minutes and you end up waiting an hour?

The way that things turn out compared to how we expected them to turn has a lot to do with how we feel.  Understanding the impact of our expectations can help us deal with the pain and frustration of loving someone with a brain-based (mental) illness.

For example, living with a person who has clinical depression is hard.  We want to help, but we don’t know how. Sometimes our efforts make things worse.  The same is true when you live with a person who suffers from anxiety disorders, bipolar disorder or the spectrum that is schizophrenia.

All of them have an intense need for love, but they often have trouble being loving in return.

What would an expert in the psychological community expect from a person with clinical depression?  Low energy, for one thing.  The depressed have so little energy that they rarely can think about other people.  So they seem self-centered.  The depressed person can feel an inner anger that life isn’t fair.  Yet, getting in arguments to try to talk them out of their hopelessness doesn’t work.

A person with bipolar disorder is expected to show signs of the illness.  The mood swings between mania and depression, with long or short periods in between, may seem as if they don’t have a rhyme or reason.  The reason is chemical, and it needs treatment.

Living alongside someone with borderline personality disorder is a true roller coaster ride.  One minute you are the best, and the next you are seen as a monster. “Walking around on eggshells” is a common description of daily life in that household.  People with this illness are in emotional pain almost all the time, and they project issues on others.

In short, people with mental illness are expected to behave in ways you don’t like.  They can no longer meet many simple expectations that we had for them before the illness.  One of the toughest issues family members have is deciding what the new expectations should be:  Can he work?  Can she do chores?  Can he join us for family dinner?  Can she take a shower without prompting?

This change has more impact on us that we want it to have.  We experience deep pain as we try to adjust,  as one thing after another becomes too much for them to do.  Grieving this loss is tough at the beginning, and it’s just as tough as time goes on.

You can measure stress by the difference between what is happening and what you think should be happening.  So your stress will be intense, unless you change your thinking about “what should be.”

At the beginning of a loved one’s mental illness, a psychologist suggested to us, “Why don’t you try not having any expectations at all?”  Easier said than done, and hard to hear.

But we learned to keep our expectations as low as possible.  To fill in the gap,  it’s wise to turn to God’s promises.  God is both sufficient and faithful,  walking with us through this valley of the shadow of death.  Abiding with the Lord can give you expectations of peace and comfort.

 

 

 

 

 

My Life as a Lighthouse

Once I asked God for an image of my life’s meaning. What I saw was a lighthouse.

That won’t seem unusual to those who’ve been to my house in summer when lighthouses become a decorative item.  We’ve always been drawn to them, and we generally buy an image of each lighthouse we visit.  Only my husband has been brave enough to climb the scariest of old spiral staircases to the top. But we both love them.

Being a lighthouse is also an image of the difference between being loving to someone who is experiencing a storm of mental illness and being codependent.  The lighthouse shines its light to guide the ships to safety.  It does not drag itself off its rock and wade into the storm in an attempt to grab the ship and drag it to safety.  It sounds the foghorn, it’s true, but it doesn’t engage in a lengthy argument about why the ship should head in its direction.

Fortunately, the lighthouse is attached to its rock, just I am attached to my Rock. So we allow the ship to use us as a guide or to ignore all our sound advice. We look strong, maybe even stronger than we feel, and we shine our light so that all can see it.

Bringing God’s Grace to Your (Sad and Scary) Situation

Do not look forward to the changes and chances of this life in fear; rather look to them with hope that, as they arise, God, whose you are, will deliver you out of them … the same everlasting God who cares for you today, will take care of you tomorrow, and every day, either by shielding you from suffering, or by giving you strength to bear it. Be at peace, then, and put aside all anxious thoughts.

I don’t think I’ve ever met anyone who has achieved this advice from Francis de Sales.  But it is a goal for me, like it is for many who love people with mental illness.

First, falling apart under a burden of worrying and anxiety will not help your loved one.  Your stability is a bedrock for them, and you need to try to keep yourself at peace as best you can.

So how? Only with God’s grace is any of this possible.  The best way to open myself up to that grace is to realize that I need to ask for forgiveness for the sin of worry … yes, it actually is a sin … and ask for grace.  I certainly can’t do it by myself.

I was listening to a sermon from Tim Keller of Redeemer Presbyterian Church, a great church in New York. He pointed out that worry actually comes out of pride and even arrogance.  We think we know what SHOULD be happening and are distraught that it’s not. So we worry.

Has God allowed something to get past Him? No. God is sovereign, and He can make even the suffering that comes from the illness … and ultimately from the fallen world … and make good come out of it for those who love Him. If we repent and reach out for grace, step by step the peace will come.